Take a Break: mHealth-assisted skills building challenge for unmotivated smokers

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 DESCRIPTION (provided by applicant): Smoking continues to be the major preventable cause of mortality in the United States, and the majority of smokers are not ready to quit at any given time. In this R01 application, we propose the innovative "Take a Break" project, a smoking cessation induction trial utilizing NRT-sampling and accessible and engaging mobile health technology, wrapped in concepts of a game. In smoking cessation research, the majority of evidence applies to the minority of smokers, those actively quitting. This known gap is significant because the majority of smokers - those who are not ready to quit smoking, also described as smokers in the "Motivation Phase" of the Phased Framework of Smoking Cessation, historically have not been the focus of cessation interventions. Components of Take a Break include a brief 3-week experience during which smokers are provided nicotine replacement therapy; given the game; encouraged to try a brief period of abstinence; rewarded with recognition points for participation; and allowed continued access to the technology. The game includes Challenge Questions to assess smoking behavior and cravings and provide immediate feedback, and a suite of tools available at the point of need to help develop coping skills. We hypothesize that, compared with the NRT-only group, the Take a Break group will have a greater number of days abstinent during the `break' period, a greater increase in self-efficacy at the end of the `break' period, a lower time to first quit attempt, and a higher rate of quit at 6 months. If Take a Break proves to be effective, it has great potential for widespread, non- traditional dissemination. Our Specific Aims are AIM 1: Refine the Take a Break mHealth tool and implementation program. AIM 2: Conduct a randomized trial of the effectiveness of Take a Break. AIM 3: Follow participants in the AIM 2 randomized clinical trial for 6 months to evaluate time to quit attempts, number of quit attempts, and 6-month biochemically verified point prevalent cessation. The Take a Break intervention is designed to increase self-efficacy and support new skills for Motivation Phase smokers. It also will provide valuable insight into this population of smokers and increase our understanding of which tools may be effective in helping them quit smoking.